Waipahu High School



Waipahu High School

Graphing Calculator Borrower’s Agreement

School Year 2012-2013

Student Name ______________________________ Date ________________________

Parent/Guardian ____________________________ Grade Level ________________

Address ______________________________ Quarter Requested ___________

______________________________ Phone Number _______________

Current Math Teacher ________________________

Math Course & Room#_______________________

I, _________________________________, agree to borrow a TI84 Plus graphing calculator from Waipahu High School Mathematics Department for Quarter _______ of the 2012-2013 school year. (Calculators may be borrowed for another quarter if supply is available)

I agree that I will do all of the following:

a) I will purchase and supply my own AAA batteries,

b) I agree to return in the calculator in the same condition from when borrowed,

c) If the calculator is damaged, lost, or stolen, I will be charged the full cost of the calculator, $125.65 ($120 calculator, $5.65 tax).

d) I will return the calculator by 2:45 p.m. on the last day of the quarter. I may re-borrow the calculator for another quarter if there are calculators available. Note: It will become a school obligation on official record until returned and/or cleared.

________________________________________ Date _________________________

Student Signature

________________________________________ ____________________________________

Parent/Guardian Print Parent/Guardian Signature

Office Use Only

Calculator Check Out Date: _______________________________ Quarter: __________

Return Date ____________________

Calculator Check In Date: _______________________________

WHS Calc. ID Number: _______________________________

Serial Number: _______________________________ Issuing Teacher_____

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